Individual
YONG MOO PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 CENTRAL AVE, EAST ORANGE, NJ 07018-2819
(973) 672-8400
Mailing address
PO BOX 827944, PHILADELPHIA, PA 19182-7944
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 26048
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0670308
—
NJ
Enumeration date
06/13/2005
Last updated
12/26/2012
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